中央区难治性癫痫的外科治疗

doi:10.19854/j.cnki.1008-2425.2023.03.0001

摘要/Abstract

摘要： 目的探讨外科治疗中央区难治性癫痫的方法和疗效。方法回顾性分析2017年7月～2021年8月诊断为中央区难治性癫痫且接受外科治疗的患者的临床资料。结果 31例患者纳入研究,其中男20例,女11例,年龄中位数是14(9,23),儿童19例,成人12例。手术切除治疗22例,平均随访3.0±1.1年,EngelⅠ级17例(77.3%),轻度神经功能障碍3例(13.6%)。射频热凝治疗8例,随访中位数1.5(1.2,1.8)年,EngelⅠ级5例(62.5%),未出现明显神经功能障碍。迷走神经治疗1例,随访2年,EngelⅢ级。结论外科治疗中央区癫痫安全有效;精准定位功能区与致痫灶的关系是保证疗效和避免神经功能障碍的关键;射频热凝术是治疗中央区癫痫的新方法。

关键词: 中央区癫痫, 癫痫手术, 射频热凝, 迷走神经刺激

Abstract: Objective To investigate the Methods and efficacy of surgical treatment of rolandicintractable epilepsy.Methods The clinical data of patients who were diagnosed with rolandicintractable epilepsy and underwent surgical treatment between July,2017 and August,2021 were retrospectively analyzed.Results A total of 31 patients were enrolled in the study,including 20 males and 11 females,with a median age of 14 (9,23),19 children and 12 adults.22 patients were treated with surgical resection,with an average follow-up of 3.0±1.1 years.17 patients (77.3%) had Engel Ⅰ,and 3 patients (13.6%) had mild neurological dysfunction.8patients were treated with radiofrequency thermocoagulation,and the median follow-up time was 1.5 (1.2,1.8) years.5 patients (62.5%) were EngelⅠ,and no obvious neurological dysfunction occurred.One patient was treated with vagus nerve stimulation and was followed up for 2 years with Engel III.Conclusion Surgical treatment of rolandic epilepsy is safe and effective.Accurate localization of the relationship between functional area and epileptogenic zone is the key to ensure curative effect and avoid neurological dysfunction.Radiofrequency thermocoagulation is a new method for the treatment of rolandic epilepsy.

Key words: Rolandic epilepsy, Epilepsy surgery, Radiofrequency thermocoagulation, Vagus nerve stimulation

中图分类号:

R742.1

石先俊, 孙晓琴, 冯林, 邓静, 张春青, 吕胜青, 刘仕勇. 中央区难治性癫痫的外科治疗[J]. 立体定向和功能性神经外科杂志, 2023, 36(3): 129-134.

Shi Xianjun, Sun Xiaoqin, Feng lin, et al. Surgical treatment of rolandic intractable epilepsy[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2023, 36(3): 129-134.

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